Combined statement and check



May 18 1926.

, R. H. VANSANT COMBINED STATEMENT AND CHECK Filed Nov. 27, 1922Patented May 18,- 1926.

nCHAnn H tvAN'sAN'T, CF CHIC-Acc, ILM-nots,

CREAMERY o0., 0F CHICAGO, immers,

AssIGno'R To BLUE VALLEY A CORPORATION or DELAWARE.

Coi/mman STATEMENT AND CHECK.

Application filed. november a?, 1922. serial No. ac3-,385.

The object of this invention is to provide a convenient blank formcomprising a statement to receive the full 'details of a transaction,and a detachable check forl settlement of the transaction, the combinedstatement and check being adapted to be filled out in a suitablemachine-which makes one or more manifold copies at the same time for apermanent record, whereby the customer is fully informed as to. the fulldetails of the transaction when he receives the statement and check insettlement thereof, and is enabled to preserve for future use the recordof such details while the check is passing through the regular bankAchannels back to the maker, and the said maker is provided with aduplicate of the details 'recorded on the statement and check so thatboth parties will have a Afull record of the transaction and the checklcan be readily identified with both the statement and the makersrecord.

In the accompanying drawings I have illustrated an embodiment of theinvention which has been used successfully and referring thereto gig. 1is a plan view of the check register, an

Fig. 2 is a plan view of the check with the statement thereto attached.

Referring to the drawings the :check 3 'and the statement 4 are printedon one sheet with an intermediate perforated line 5 to 'facilitate theirseparation. The check part 3 differs from the Aordinary bank check inthat the space 6 in which the l:r'iain'e of the bank is preferablyprinted and the space 7 for the signature'of'the maker kare located atthe upper part of the check above the space S to vreceive the name, withor without the address,- of the payee, and the number of 'the check islocated at '9 and the amount ofthe check is located at 10 in a line`adjacent the bottom of the lcheck'. The date 11 may be convenientlylocated las shown in 'a blank space above the payee space. The check mayhave printed thereon the usual authorization to the bank for paymentandsuch other p inscriptions as may be desirable for identification orother purposes,

The statement 4 has a date space 12. The date spaces on the check andstatement are preferably located adjacent to the perforated line 5 andin substantial alignment with each other for convenience in filling in'the date. At the bottom of the statement and check there are aplurality kof spaces 13 arranged in a line for recording 4the completedetails of the transaction and these spaces are indicated by printedlegends 14 suitable fortransactions in a certain line of business. Theselegends will vary more or less as the invention is used In differentlines of business but they are preferablyl located closely adjacent 'to'the bottom edge of the Vstatement and check so that the particulardetails may be readily inserted by means of the machine which is used inmaking; lout the check and statement. The statement is also providedwith such printed instructions, directions or guarantees as may besuitable for the line `of business in which the check is used and thesealso may be varied as desired. y i

The invention is illustrated as adapted for use in 'a Creamery wheremilk or cream is received, weighed, tested and paid for by cl'reck everyday and the items of the transaction are plainly set* forth on thestatement and identified with the check. The statement shown has legendsand spaces thereunder lin which to record the amount of cream "received,its test vandbutter fat, the price, gross amount, deductions and netamount to Vbe paid'; and the check has a space for the check number andthe net amount to be paid. The spaces for insertion of thesetransactions are located adjacent to the lower edge of the statementandV ch'eck so that the figures 'may be readily in` ser'ted on asuitable machine.

The check register 15 of Figure 1 hasv aline of legends across the sheetcorrespond.- ing to the 'legends at the bottom of the statement and-alsoa Check No. legend corresponding in position to that legend on the checkwith a Date paidl legend on one side thereof and Remarks Ilegend on theother side thereof, This arrangement is made so that a manifold `copy ofthe original figures printed on the statement andv check may be made onthe check register and they will appear under 'the proper legends orheadingon the register just as they appear on the statementand check.

I have explained that the spaces for the details of the transactions arelocated adjacent the lower edge of the statement and check forconvenience in printing the items thereon, but this has a further objectof very material importance. The check register is provided With a space16 to receive a date to designate the day when the cream was receivedandopaid for and this date is inserted in the machine. The register Witha sheet of carbon paper on the front thereof is then turned with theroller platen of the machine until the spaces under the legends orheadings are in impression position. The check register and its carbonsheet are arranged in the machine in accordance With the usual manner ofplacing a sheet in the ordinary typewriting machine, but the check isslipped into place at the front of the platen roller and iin front 0fthe carbon sheetsothat the spaces for items of the transaction will belocated in impression position under the corresponding` spaces on thecheck register. After the record is made the carriage is fed forward onespace after the manner of the ordinary typewriting machine Whichreleases the check and spaces the check register for another check sothat the lines of impressions on the check register are close togetherlike single spacing on a typewriter, whereby a single check register maycarry the record of a great many checks.

The check and the check register are numbered for identification andwhen the check is returned through the banks to the maker an entry ofthe date is made on the check register under Date paid to indicate thatthe transaction is closed. The checks may be numbered consecutively orotherwise so that they can be readily identiiied. I have found itconvenient to group the checks for each day and number the groupsconsecutively, providing a separate check register for each group whichis numbered corresponding to the group. numbered consecutively so thatthe rst check in a group recorded on sheet 1 of the check register Willbe numbered '1-1, the second 1-2 and so on. For the second group andsecond page of the check register the number Would be 2--1 and 2--2 andso on. Thus the date and number on the check refers directly to theparticular register sheet and line thereon to which the check belongs sothat the paid entry may be readily made when the check is returned.' Ifany question arises between the payee and the maker of the check Withrespect to the transaction it is not necessary for the payee to returnthe check because he and the maker both have a full itemization of theWhole transaction and can correspond With reference vthereto by simplyreferring to the check number or the date and the items of thetransaction which Will be suiiicient to enable 'Ihe checks in a groupare also Y the iternsof the transaction on the bottom of the statementand check and on the check register by means of a billing machine.

My invention provides a simple and easy means whereby a large amount ofbusiness can be very expeditiously transacted and a complete recordfurnished to each transaction giving all the details thereof andprovided with suitable checks so that they can be readily identified.The location of the spaces for rcceipting the transaction items at thebottom of the combined statement and check is of special importance asherein pointed out particularly because it enables these items to berecorded on a single line on the statement and check and also enables amanifold copy of the items on a plurality of checks to berecorded inclose spacing on the register sheet.

For convenience in description I have referrcd to the part 3 as thecheck and the part 4L as the statement but both of these parts, Withoutbeing separated, are sent to v the scope of the following claim.

I claim:

A combined statement and check consisting of a strip having a separationline dividing it into a statement part and a check part, the statementpart having approximately designated spaces arranged in a line adjacentits bottom edge to receive items of a transaction and the check parthaving appropriately designated spaces in a line adjacent its botom edgeto receive the amount of the check in Words and in figures, said spaceson the check part being arranged in alignment with said spaces on thestatement part, the check part also having appropriately designatedspaces for the name of the maker and the name of the bank and for thename and address of the payee.

RICHARD I-I. VANSANT.

